Individual provider Active NPI

Kimberly A Owens, O.D.

  • Optometrist
  • Springdale, AR
National Provider Identifier
1467444026
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2520 Issued in AR
Practice address
1602 E Robinson Ave
Ste. M
Springdale, AR 72764-5991
Phone
(479) 750-9996
Fax
(479) 750-9922
NPI assigned
Aug 19, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2520 AR Primary

Addresses

Primary practice location

1602 E Robinson Ave
Ste. M
Springdale, AR 72764-5991

Mailing address

1602 E Robinson Ave
Ste. M
Springdale, AR 72764-5991

Other identifiers 1

IdentifierTypeStateIssuer
154495722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040726000713 AR Practitioner - Optometry 1951381292

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1079 E Don Tyson Pkwy
Springdale, AR 72764-7201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly a. Owens, Optometric Physician, PA Optometrist CurrentSince Jul 15, 2004 Accepting new patients
McDonald Eye Services, PA Optometrist Past Accepting new patients
David and Deanne Witherspoon, Optometry, P.a. Optometrist Past Accepting new patients

Locations

1602 E Robinson Ave
Ste M
Springdale, AR 72764
Phone (479) 750-9996

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1467444026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 E ROBINSON AVE",
            "address_2": "STE. M",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 E ROBINSON AVE",
            "address_2": "STE. M",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727645991",
            "telephone_number": "479-750-9996",
            "fax_number": "479-750-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154495722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.